After a hiatus of more than a month, health care reform is again the focus of op-editorialist Paul Krugman's column in The New York Times. He borrows his title ("One Nation, Uninsured") from Florida State Prof. Jill Quadagno's March 2005 study of health policy failures and options in the United States. I haven't read Quadagno's book yet, but the Booklist review says her recommendations for reform include "a federal 'stop-loss' program that would assist businesses and individuals facing catastrophic health-care losses not covered by insurance." For his part, Krugman argues for nothing less that a national, universal, single-payer system:

A system in which the government provides universal health insurance is often referred to as "single payer," but I like Ted Kennedy's slogan "Medicare for all." It reminds voters that America already has a highly successful, popular single-payer program, albeit only for the elderly. It shows that we're talking about government insurance, not government-provided health care. And it makes it clear that like Medicare (but unlike Canada's system), a U.S. national health insurance system would allow individuals with the means and inclination to buy their own medical care.

Krugman brushes aside the suggestion that powerful lobbies (including most conspicuously the insurance industry) will succeed, as in the past, in defeating sweeping reform. Part of his reasoning is that conditions in the U.S. are approaching the "perfect storm": "The cost of health care is exploding, the number of uninsured is growing, and corporations that still provide employee coverage are groaning under the strain." With memories of the insurance lobby's anti-reform efforts of 1993-94 still fresh, Krugman is obviously hoping that health-reform that merely buildings on the status quo will be less appealing than they were a decade ago.